The retention of students presents a challenge to approved education institutions (AEIs) globally. Nursing student attrition is of particular concern owing to the high non-completion rates and financial costs. A survey approach was used in an AEI in the north of England to explore the views of five cohorts of pre-registration student nurses on factors influencing continuation. In total 594 questionnaires were distributed, of which 195 (32.8%) were completed; 52.3% of respondents had considered leaving. "Pull" factors contributing to their decision to stay included support structures (academic/family/peer) and a determination to become a nurse. "Push" factors, which had led students to consider leaving, included financial difficulties, personal pressures, poor placement experience and academic difficulties. The study identified key areas for AEIs to focus their efforts in optimising student retention: enhancing mechanisms supporting students around financial, personal, clinical and academic pressures, and developing curricula that celebrate the uniqueness and value of nursing.